核素脑池显像对脑脊液循环障碍的评估  

Evaluation of circulatory disturbance of cerebrospinal fluid with radionuclide cisternography

作　　者：童冠圣[1] 文哲[1] 樊军[1] 胡志强[2] 关峰[2] 李征[1] 

机构地区：[1]首都医科大学附属北京世纪坛医院核医学科,100038 [2]首都医科大学附属北京世纪坛医院神经外科,100038

出　　处：《中国微侵袭神经外科杂志》2011年第7期291-293,共3页Chinese Journal of Minimally Invasive Neurosurgery

基　　金：北京世纪坛医院科研基金(编号:2008-16;2009-23)

摘　　要：目的探讨核素脑池显像的影像特征及其对脑积水脑脊液循环障碍的评估价值。方法回顾性分析72例经CT或MRI证实为脑积水病人的临床资料,根据年龄分为儿童组(37例)和成人组(35例)。均行核素脑池显像检查。结果经核素脑池显像诊断交通性脑积水38例,其中儿童21例,成人17例;大脑凸面显像剂分布减少或无分布30例(79%),分布接近正常8例(21%);儿童组伴颅内蛛网膜囊肿10例(48%),成人组伴颅内蛛网膜囊肿2例(12%),交通性脑积水病人未发现囊肿与蛛网膜下腔相交通。非交通性脑积水34例,其中儿童组16例,成人组18例;大脑凸面显像剂分布减少或无分布17例(50%),分布接近正常17例(50%);儿童组伴颅内蛛网膜囊肿5例(31%),其中囊肿与蛛网膜下腔相交通3例,成人组伴颅内蛛网膜囊肿2例(11%),未见囊肿与蛛网膜下腔交通。结论核素脑室显像有助于鉴别脑积水的类型和脑脊液吸收情况,并可判断蛛网膜囊肿是否与蛛网膜下腔相通,对选择合适的治疗方案有重要参考价值。Objective To investigate the imaging characteristics of radionuclide cisternography（RC） and its evaluation value for circulatory disturbance of cerebrospinal fluid（CSF） in patients with hydrocephalus.Methods Clinical data of 72 patients with hydrocephalus confirmed by CT or MRI were analyzed retrospectively.The patients were divided into child group（n=37） and adult group（n=35） according to the age,and RC were performed in all the patients.Results Communicating hydrocephalus was diagnosed by RC in 38 cases,including 21 in child group and 17 in adult group.RC showed decrease or absence of radiotracer distributing in cerebral convexities in 30 cases（79%）,and closed to normal in 8（21%）.Communicating hydrocephalus accompanied by intracranial arachnoid cysts were found in 10 cases（48%） in child group and 2（12%） in adult group,and there was no communication between the cysts and subarachnoid space.Non-communicating hydrocephalus was diagnosed by RC in 34 cases,including 16 in child group and 18 in adult group.Radiotracer in the cerebral convexities decreased or lacked in 17 cases（50%）,and closed to normal in 17（50%）.Non-communicating hydrocephalus accompanied by intracranial arachnoid cysts was found in 5 cases（31%） in child group and 2（11%） in adult group,and there was a communication between the cysts and subarachnoid space in 3 cases in child group and no one in adult group.Conclusions RC is useful to distinguish the types of hydrocephalus,observe the absorbing state of CSF and judge the communication between intracranial cysts and the subarachnoid space,thus being important for selecting optimal management for hydrocephalus.

关 键 词：脑积水 放射性核素显像 蛛网膜囊肿 

分 类 号：R742.7[医药卫生—神经病学与精神病学]